Many individuals with sexual interest in children express a desire for mental health services but represent an underserved client population. An identified barrier to service provision is mandatory reporting legislation, which requires clinicians to report when they learn of a child who has been, or is at risk of being, sexually abused. We conducted a vignette study to examine the factors that would influence mandatory reporting decision-making when a client discloses sexual interest in children. We recruited a convenience sample of 309 Canadian registered mental health clinicians and student trainees who completed several questionnaires. Clinicians were randomized to one of nine vignettes that were crossed on two situational factors (use of child sexual exploitation material and access to children). The results of the multivariate analysis suggested that stigma towards people with sexual interest in children was associated with an increased likelihood of reporting. Clinicians were more likely to indicate that they would report the hypothetical client was viewing child sexual exploitation material and/or had access to children. These findings are discussed within the context of improving service provision to the underserved population of people with sexual interest in children.
Individuals with a sexual interest in children who have not committed a sexual offense are a client population that are currently underserved by psychologists. In the context of accessing and providing mental health services, mandatory reporting laws represent a key issue for clients and psychologists. For clients, mandatory reporting requirements creates a double-bind: They wish to access psychotherapy for a myriad of psychological concerns, yet they fear the implications of psychologists' mandated reporting requirements if they disclose their sexual interest. Psychologists treating nonoffending clients with sexual interests in children face several overlapping and competing ethical and legal obligations created by mandatory reporting laws. To examine these complexities, the present article reviews and discusses legislation in Canada, complaints to provincial professional colleges, and case law related to mandatory reporting requirements. We additionally review principles and standards in the Canadian Psychological Association's Code of Ethics (4th ed.) to inform service provision with these clients. Recommendations for practice are provided based on this discussion, and practice case vignettes are given to facilitate ethical decision-making.
Abstract:Child sexual abuse is a global problem with significant emotional, psychological, and financial implications to victims, perpetrators, and society. Most child sexual abuse prevention programs target young children or those who have already engaged in abusive behavior, in order to prevent further offending. There are numerous secondary prevention programs targeting individuals at-risk of various health conditions in an effort to reduce the likelihood they will go on to experience a particular illness or disease. Considerable research exists regarding the risk factors for engaging in child sexual abuse and more specifically the factors contributing to reoffense. We argue that engaging in secondary prevention programs for people with pedophilia, in order to prevent child sexual abuse, is an ethically responsible and necessary practice. Secondary prevention programs with this focus are reviewed, along with the implications of mandatory reporting in doing this work.
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